By a coincidence last week saw both the announcement of the coalition government’s shake up of the NHS, and the start of this summer’s season of ritual humiliation in The Dragons’ Den. On the face of it these two events have little in common, but it does not take long to see that The Dragons’ Den is in fact the model for the coalition’s vision of GP based commissioning. Most jobbing doctors will see it as an irritation and a diversion, but a hardcore of latent fundholders will emerge – indeed already have emerged – to grasp what some have called a poisoned chalice, but what Dr Dollar will see – indeed already has seen – as a Golden Opportunity. Before we know it, Dr Dollar and his pals will form up into consortia, and the BBC will spot a chance for another easy reality show. The GPs’ Den will be the new Dragons’ Den.
WINGNUT (to camera, rubbing hands together gleefully): Welcome to this, out first ever GPs’ Den. We have a clutch of hopeful providers, all keen to pitch their ideas to our loaded GPs. First up tonight is Karen, a homeopath from Milton Keynes.
Throbbing hypnotic Dragons’ Den style music. Cut to panoramic shot of five smug GPs sitting in leather chairs, each with a table at their side piled high with smackers. One of the GPs is smoking a fat cigar. Pan to steel staircase, where Karen the homeopath is climbing nervously up to the GPs’ den. She walks across to a display stand, removes the drape to reveal a large drawing of an empty bottle, and turns to face the GPs.
KAREN: Hi. I’m Karen. (bursts into tears, deep sob, then recovers) I’m here today to ask for £100,000 of your money. In return, I’ll provide homeopathy services to all your patients for 12 months.
GPs all shake their heads knowingly while making notes on their iPads. The piles of smackers have miraculously doubled in size.
WINGNUT (voiceover): Karen’s started shakily, and the GPs aren’t impressed.
DR PETER BONES: Hi Karen, I’m Peter. I tried a homeopathic remedy once, and it didn’t work.
KAREN: Oh, how awful for you!
DR BONES: No, Karen, how awful for you. I’m out.
Karen suppresses a sob.
DR THEO PROSCIUTTO: Tell me a bit about your background and training.
KAREN (visibly brightens): I work at Boot’s. I saw how well homeopathic remedies sell, and so I went on this weekend course…
DR PROSCIUTTO: Weekend Course? You are so far away from reality – whatever you do, do not give up your day job. I’m out.
Karen gives a little sob, then recovers.
WINGNUT (voiceover): It’s not going well for Karen. The GPs may be spending your money, but they will only spend on treatments they personally believe will work.
DR DUNCAN BALLANTINE (slumped in chair, shaking head; sotto voce): Bizarre…yon lass is quite bizarre…quite quite bizarre…
DR DEBORAH MOODY (now partially hidden behind the piles of smackers which have once again miraculously doubled in size): Hi Karen, I’m Deborah.
KAREN: Hi Deborah.
DR MOODY: Tell me about the numbers.
KAREN (struggling): Well, it goes like this. We start with a small amount of active substance, and then we dilute it several times. Each time we dilute it a hundred fold, and each dilution counts as a ‘C’, so if we do twenty dilutions, then that makes a 20C remedy. The more dilute, the more potent it is. Sometimes we use 200C remedies.
DR MOODY (crossly): But what about turnover?
KAREN: We do that when we are doing the dilutions.
DR BONES (leaning forward): I think you have spent a lot of time under water recently. It can’t possibly work. Only family, friends and idiots would tell you it does.
DR MOODY: I can’t invest in quack remedies that don’t have anything in them, so I’m out.
Karen gives a little sob again.
DR PROSCIUTTO (convulsive giggle, then pulls himself up and tries to look serious): I would rather stick a red-hot poker in my eyes than use homeopathy. (suppresses another giggle with great difficulty)
WINGNUT (voiceover): It’s not going at all well for Karen. The coalition may have given GPs more money than they know what to do with, but it looks as though our GPs wont spend it on Karen.
DR BALLANTINE (to himself): Bizarre…quite bizarre…(looks up)…homeopathy is bizarre, your proposal is completely bizarre, which must mean you are bizarre. I’m out. (slumps back down in chair, and becomes invisible because the wads of smackers have once again miraculously doubled in size)
Dr RICHARD FARAWAY (dreamily): Hi Karen. (camera lingers on Dr Faraway’s bouffant hairstyle) I think this could work. After all, we GPs are running small businesses, and as small businesses, we know the punter is always right. If they want homeopathic remedies, let them have homeopathic remedies. I’m in! (gets up and walks towards Karen, who is already dancing with glee)
KAREN: Wonderful! Oh how wonderful! (Dr Faraway and Karen embrace; camera pulls back as other GPs clap, all that is except Dr Ballantine who continues to shake his head)
DR BALLANTINE (to himself): Bizarre…the man’s bizarre…spending all that money on a treatment that can’t possibly work…quite bizarre…(continues to shake head as Dragons’ Den style music fades in)
WINGNUT (in ante-room, to camera): Well that’s amazing – Karen pulled it off! It just goes to show – GPs may hold the purse strings now, but that doesn’t mean they’ll know what to spend it on. Next up is Fritz, a Lithuanian orthopaedic surgeon with a special offer on hip replacements…